A pharyngeal fistula may follow any opening into the cavity of the pharynx through the tissues of the neck. Transhyoid approach to the interior of the pharynx or removal of the larynx is occasionally followed by a fistula. As a rule, the fistula closes spontaneously or after the usual plastic procedure.
The straight line incision used in the removal of the larynx, coupled with proper and adequate drainage, has helped a great deal to prevent the formation of fistulas.
The fistula is caused by loss of continuity in the pharyngeal wall. The exciting cause is devitalization of the tissues by infection.
In cases in which irradiation has been done before operation the changes in the tissue, both histologic and biologic, are such that union rarely occurs or when it does occur spontaneously, it is usually a long time postoperatively (figs. 1 and 2).
In two cases that are reported, the
IMPERATORI CJ. A METHOD OF CLOSING A PHARYNGEAL FISTULA FOLLOWING LARYNGECTOMY. Arch Otolaryngol. 1937;26(2):179–186. doi:10.1001/archotol.1937.00650020195006
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